The traditional Medicare consists of the Part A and Part B benefits, which lay the ground for other additional coverage such as Medicare Advantage and the Medicare Supplement.
Medicare Supplement also called Medigap is a private healthcare insurance policy provided by the private insurance companies to take care of the out-of- pocket costs that the traditional Medicare does not provide.
Medicare Advantage (Part C) on the other hand is a government program offered by the private insurance companies as an alternative to the original Medicare. Medicare Advantage plan s Part A and Part B. Some companies include Part D in their Medicare Advantage policy.
Are the plans of Medicare Advantage vs Medigap similar?
Medicare Advantage offers very different plans from Medigap. Plans offered in the Part C plan include Health Maintenance Organization and PPO, which is most common. Other policies include MSA, HMO-POS, Private Fee-for-Service (PFFs), and Special Needs Plan (SNP).
All plans in MA must cover the same benefits in the Original Medicare, although the copayments are slightly lower than in the traditional Medicare. Part C Plan costs vary by state, and it has an annual limit on the out of pocket costs. Remember that the MA costs are different from the Medicare B premiums that you have to pay every month.
Medigap plans are similar in all states except for the Wisconsin, Massachusetts, and Minnesota. Federal government standardizes the plans meaning that all the policies sold by different insurers have similar benefits.
Ten alphabetical letters starting from A to N decode the Medicare Supplement Plans. Each of the plans offers unique benefits, but Plan F remains to be the most popular than all other plans. Call us today if you need help choosing the ideal Medigap plan that suits your needs.
What are the distinguishing features in Medicare Advantage Vs Medicare Supplement?
Enrollment Period- you can only enroll or switch MA plans during the Fall Open Enrollment period but not at any other time. Medigap plan, on the other hand, welcomes application at any time of the year.
However, it is advisable to enroll during the Open Enrollment period that runs within the first six months from the first day that you acquired the Part B plan or turned 65 years old.
Doctors and Hospitals- the Medicare Supplement plan applies to any facility or doctor that accepts Medicare patients. You do not need any referrals from a specialist if you are on the Medigap plan.
Medicare Advantage uses networks with physicians and hospitals for treatment. You may also need a referral for you to receive health care services from the network specialists.
Premiums- you must pay both monthly rates and Part B premiums if you are in a Medigap policy. There are very low or no out- of-pocket costs when you use the service. Medicare Advantage vs Medicare Supplement plan, on the other hand, has very low monthly rates in addition to the Part B premium. However, the insured under this policy makes coinsurance, copayments, and deductibles payment while using this service.
- Renewal: Medicare Advantage is subject to annual renewal, and the benefits are bound to change every year. You can leave from the plan only during the Annual Election Period or During the Disenrollment period. The state government lays out the laws in the Medigap plans, meaning that the benefits do not change easily. You have a guaranteed renewal every year as long as you maintain a constant premium payments method.
- Eligibility: you are entitled to a Medigap plan if you enroll during the open enrollment period. However, the insurance company may deny you coverage if you have a pre-existing condition or increase your premiums if outside the open enrollment period. Some states also allow applications for anyone who is below 65 years old too. Anyone can enroll in the Medicare Advantage plan except for people with an end-stage renal disease.
What are the benefits of Medicare Advantage Vs Medicare Supplement?
Medigap provides benefits such as deductibles, copayments, and coinsurance. Some companies cater for the emergency care provided out of the country. Medicare Advantage (MA), on the other hand, may require you to pay deductibles, coinsurance, and copayments, but at a lower cost than the Original Medicare.
Additionally, most of the MA policies provide Part D plan that covers the prescription drugs. The two healthcare plans offer extra coverage such as vision and hearing care as well as health wellness programs, although, the services vary from one insurer to another. We are eager to take you through the various benefits provided by each of the plans in detail. Call us today!
How do I choose Medicare Advantage Vs Medigap plan?
The different characteristics of the two policies make one plan ideal in one situation but fail to work in another. Our skilled professionals will help you to arrive at the best plan depending on your budget and preferences. Some of the factors that you should consider while choosing the best insurance plan between the two include:
- Lifestyle choices: Medicare Supplement plan provides emergency services for anyone traveling out of the United States for up to 60 days hence ideal for travelers. Additionally, the plan is also open for use in any hospital in the 50 states that offers Medicare services. Medicare Advantage limits operations to a particular region hence a better choice for anyone with limited movements.
- Budget: Medicare Advantage costs are slightly lower and sometimes cover more services than the Original Medicare hence ideal for anyone struggling with a tight budget. Medigap, on the other hand, has higher monthly premiums but no or vary little out-of-pocket expenses.
- Location and Choice: Medicare Advantage limit you to the on-network doctors and facilities. The plan may fail to cover any health care service provided out of network too. Medigap, on the other hand, provides coverage for any health care provided by any doctor or facility that offers Medicare.
Can I add Medigap plan to my existing Medicare Advantage?
Medigap is different from Medicare Advantage in many ways, but you should never have the two at once. The private insurance companies should only enroll you in Medigap insurance only if your promise to drop the Medical Advantage or vice-versa. To find information on the best medicare advantage plans click here.